Object Transcending Obamacare

Posted: 8/17/2014

Trigger

Avik Roy of the Manhattan Institute just published his “TRANSCENDING OBAMACARE A Patient-Centered Plan for Near-Universal Coverage and Permanent Fiscal Solvency” proposal called Universal Exchange Plan. Mr. Roy is introduced as one of the architects of RomneyCare in Massachusetts. It is ill conceived and it is not a repeal and replace kind of alternative as claimed. It aims to retain way too much of what ails the U.S. health care system.

In this blog post I will only refer to the Executive Summary of the above document.

Principles Missed By The Manhattan Institute

Any classical liberal would probably approach the healthcare issue as follows:

1. Get government out of the way as much as possible (not so Mr. Roy)
2. Establish free markets for private individual health care for every adult and their children (like any other insurance; not so Mr. Roy)
3. Privatize all existing government programs (e.g. Medicare, Medicaid, Veterans, Chips etc.) using a transition phase and free choice for citizens (not so Mr. Roy)
4. Employer sponsored health care should be discouraged. Most employers are not in the business of health care. It should be the free and voluntary decision of any employer whether or not and what kind of health care and for how long they offer their employees. (not so Mr. Roy)
5. Government should only be concerned supporting the really poor with obtaining decent health insurance or to support individuals who suffered catastrophic health events (not so Mr. Roy)

Of course, the many detractors of all persuasions will simply say this is impossible or unrealistic! Is it really impossible to start over towards more individual freedom and responsibility and towards a much more smaller and limited government?

Main Points Of The Proposal

The Manhattan Institute relies way too much on saving Obamacare and fix it like a surgeon.

The Universal Exchange Plan proposes (emphasis added):

1. Repeal of the the individual mandate and employer mandate
   [It does not repeal the insurance mandate, which suggests it does not deal with exaggerated government mandated coverage. This is quite inconsequent.]
2. Restores the primacy of state-based exchanges and state-based insurance regulation
   [Does this mean, there will be no cross state competition of health insurers?]
3. Medicare reform. The Plan gradually raises the Medicare eligibility age by four months each year. The end result is to preserve Medicare for current retirees, and to maintain future retirees
   [This government program like others needs to be phased out, see above principles]
4. Other reforms. The Plan tackles the growing problem of hospital monopolies that take advantage of their market power to charge unsustainably high prices. [The Executive Summary is moot on how to do that. How about more competition for hospitals Mr. Roy]
5. To preserve the Cadillac Tax. [What is this good for?]

Conclusion

I think Mr. Roy said it best himself “What it tries to do is to stitch together ideas from all sides to fix flaws in the system, new and old.” (emphasis added). This plan is by its own admission a quilt of flawed compromises suiting political expediency and feasibility. It does not have the citizen of We The People in mind!